在临床实践中fluticasone furoate和vilanterol对喘控制的有效性:一个开放式,并行组,随机对照试验
Ashley Woodcock1, Jørgen Vestbo1, Nawar Diar Bakerly2
1Division of Infection, Immunity and Respiratory Medicine, Manchester Academic Health Sciences Centre, University of Manchester and University Hospital South Manchester NHS Foundation Trust, Manchester, UK.
Lancet (London, England)
|September 15, 2017
概括
与常规治疗相比,开始用酸和维兰特洛治疗的患者的喘控制显著改善. 这种组合疗法可以改善喘控制,但不会增加严重副作用的风险.
科学领域:
- 肺病学
- 临床试验
- 药物治疗
背景情况:
- 目前的喘治疗依赖于对特定患者群体的疗效试验.
- 需要随机试验来反映现实世界的临床实践.
研究的目的:
- 为了比较在症状性喘中启动酸/维兰特罗的疗效与通常治疗的疗效.
- 在一般实践中评估喘控制的改善.
主要方法:
- 一个开放的,随机的,受控的试验,涉及74个英国的一般实践.
- 接受维护性吸入剂的症状性喘患者被随机分配到酸/ 维兰特罗或常规治疗.
- 主要终点是在24周达到喘控制测试 (ACT) 评分≥20或增加≥3.
主要成果:
- 在24周开始使用fluticasone furoate/ vilanterol的患者中,反应率更高 (OR为2. 00,p< 0. 0001).
- 调整后的ACT平均得分增加了4. 4分,而在常规治疗中增加了2. 8分 (差异为1. 6, p< 0. 0001).
- 两组之间没有观察到肺炎或其他严重不良事件的显著差异.
结论:
- 每天服用一次酸/ 维兰特洛可改善维护性吸入器患者的喘症状.
- 与优化的常规治疗相比,这种治疗方案是有效和安全的,没有增加严重不良事件的风险.
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